are sinus sprays less impacting on milk supply than oral meds?

[nomidee]

Hello again,
I have a Q regarding mothers with congested sinuses. If traditional methods such as saline irrigations or sprays, humidifiers etc are not helping the mother and she is desperately needing something to clear them, would a phenylephrine spray or something along those lines be safer than trying a tablet decongestant which can severely impact supply?
I'm thinking that if it's locally acting her plasma levels will be pretty low, and that will reduce the impact on milk supply and potential for crossing into breastmilk?
Regards
Naomi

[cpride]

Dear Nomidee,

Yes, topical application of decongestants reduces the risk to the mother's milk supply compared to oral use. We recommend either a topical decongestant such as oxymetazoline (can be used for up to 3 days) or a topical steroid such as mometasone nasal spray or triamcinolone nasal spray. If oxymetazoline is used, observe infant for insomnia, nervousness and excitation. It should not be used if the infant has cardiac symptoms or hypertension. Short term use of a topical steroid would not be expected to impact infant growth. Only 0.7 percent of intranasal mometasone is absorbed systemically over eight hours and intranasal triamcinolone also is minimally absorbed systemically. Let me know if you have further questions.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center